[1]王晨 林功晟 马慧芬 陶晓华 周雅俊.基于变异系数探索DIP病种同质化管理路径[J].中国卫生质量管理,2024,31(11):039-42.[doi:10.13912/j.cnki.chqm.2024.31.11.09]
　WANG Chen,LIN Gongsheng,MA Huifen.Exploring the Path of Homogeneous Management for DIP Disease Based on the Coefficient of Variation[J].Chinese Health Quality Management,2024,31(11):039-42.[doi:10.13912/j.cnki.chqm.2024.31.11.09]
点击复制

基于变异系数探索DIP病种同质化管理路径()
分享到：

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R]

卷:
第31卷
期数:
2024年11期
页码:
039-42
栏目:
医疗质量
出版日期:
2024-11-15

文章信息/Info

Title:
Exploring the Path of Homogeneous Management for DIP Disease Based on the Coefficient of Variation
作者:
王晨 林功晟 马慧芬 陶晓华 周雅俊
上海中医药大学附属第七人民医院
Author(s):
WANG Chen;  LIN Gongsheng;  MA Huifen
The Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine
关键词:
按病种分值付费（DIP）; 变异系数（CV）; 同质化诊疗; 病种管理
Keywords:
Diagnosis-Intervention Packet（DIP）; Coefficient of Variation（CV）; Homogenized Diagnosis and Treatment; Disease Management
分类号:
R197.3
DOI:
10.13912/j.cnki.chqm.2024.31.11.09
文献标志码:
A
摘要:
目的基于变异系数（CV）分析同质化程度较低的DIP病种，探索管理路径。方法对某三甲医院26 894例病种417个DIP病种组计算费用和时间CV，结合病种难度分布和标化费用合理区间进行费用同质化相关性分析，识别重点病种和关键问题，提出DIP病种同质化管理思路。结果DIP病种同质化程度不同，时间和费用同质化程度均较低的病种（CV≥0.6）占26.34%，费用CV≥0.6的病种更易出现异常费用情况且分布在高难度病例；时间和费用CV均≥1的病种占总例数的3.60%，主要为肿瘤或急危重症等住院日长的病种，此类病种为重点问题病种，需进行同质化管理。结论DIP病种存在部分同质化程度低的组别，医疗机构应监测各病种费用和时间CV值，重点管控CV≥1的病种，针对性建立同质化管理路径，实现DIP病种精细化管理。
Abstract:
ObjectiveTo analyze the DIP diseases with low degree of homogeneity based on coefficient of variation (CV), and to explore the management path.MethodsThe cost and time CV of 417 DIP groups of 26 894 diseases in a tertiary hospital were calculated. Combined with the difficulty distribution of diseases and the reasonable interval of standardized cost, the correlation of cost homogenization was compared and analyzed. The key diseases and key problems were identified, and the idea of DIP diseases homogeneous management was put forward.ResultsThe degree of homogenization of DIP diseases was different. The diseases with low degree of homogenization of time and cost (CV≥0.6) accounted for 26.34 %. The diseases with cost CV ≥ 0.6 were more likely to have abnormal costs and were distributed in high-difficulty cases. The diseases with time and cost CV≥ 1 accounted for 3.60 % of the total cases, mainly for the diseases with long hospitalization days such as tumors or acute and critical diseases. These diseases are the key problem diseases and need to be homogenized.Conclusion There are some groups with low degree of homogeneity in DIP diseases. Medical institutions should monitor the cost and time CV value of each disease, focus on controlling diseases with CV ≥ 1, and establish a homogeneous management path to achieve refined management of DIP diseases.

参考文献/References:

［1］国家医疗保障局. 关于印发DRG/DIP 支付方式改革三年行动计划的通知：医保发〔2021〕48号［EB/OL］. (2021-11-19)［2024-05-22］. http://www.gov.cn/zhengce/zhengceku/2021-11/28/content_5653858.htm.［2］于保荣. DRG与DIP的改革实践及发展内涵［J］. 卫生经济研究, 2021, 38(1): 4-9.［3］许 速,谢 桦,崔 欣,等.基于大数据的病种分值付费的原理与方法［J］.中国医疗保险,2020(9):23-28.［4］田 帝,周 典,周 苑,等.临床路径管理与DRG支付方式改革协同关系研究［J］.中国医院管理,2022,42(10):13-17.［5］蔡 慧,胡龙军,丁明明,等.基于三级综合医院病种特点的临床路径管理［J］.中国卫生质量管理,2022,29(3):30-32.［6］舒 琴,李 迪,孙 扬，等.基于变异系数计算的DRG本土化应用分析及建议［J］.中国医院管理,2019,39(8):43-45.［7］国家医疗保障局. 国家医疗保障按病种分值付费（DIP）技术规范［Z］.2020.［8］贾晓倩,王 珩,蒋心梅,等.医保DRG付费改革下某三甲医院分级诊疗下沉病组路径初探与思考［J］.中国医院,2022,26(9):6-9.［9］龙雨曦,袁向东,黎浩.我国医保支付改革下按病种分值付费的探讨与建议［J］.中国卫生质量管理,2022,29(4):18-20，29.［10］李梦滢,孙志成,唐 尧，等.基于DRG的公立医院临床路径管理体系建设［J］.卫生经济研究,2022,39(2):67-69，74.［11］尹 畅,王建伟,刘倩楠,等.以单病种过程质量管理促进临床诊疗同质化［J］.中国卫生质量管理,2022,29(7):12-14，21.［12］黄秋华,罗小丽.开展DRGs对提升病案编码员肿瘤疾病分类能力的相关对策［J］.医学理论与实践,2018,31(20):3157-3158.［13］周婧雅,白 雪,崔胜男，等.我国ICD-10疾病分类编码质量的系统评价［J］.中国医院管理,2015,35(12):32-35.［14］贺 哲,张 杰,翁雨雄,等.DRG支付方式改革下大型公立医院临床路径实施策略分析［J］.中国医院管理,2024,44(4):70-73.［15］王 晨,林功晟,马慧芬，等.基于DIP的主诊组绩效考核指标体系构建及应用：以中西医结合医院为例［J］.中国卫生质量管理,2023,30(3):55-59.

相似文献/References:

[1]王晨林功晟马慧芬*王杰宁陶晓华周雅俊.基于DIP的主诊组绩效考核指标体系构建及应用：以中西医结合医院为例[J].中国卫生质量管理,2023,30(03):055.[doi:10.13912/j.cnki.chqm.2023.30.3.11 ]
　WANG Chen,LIN Gongsheng,MA Huifen.Construction and Application of DIP-Based Performance Appraisal Index System in the Main Clinic Group: a Case Study of Integrated Chinese and Western Medicine Hospital[J].Chinese Health Quality Management,2023,30(11):055.[doi:10.13912/j.cnki.chqm.2023.30.3.11 ]

更新日期/Last Update: 2024-11-15